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Brachytherapy for intracranial meningioma using a permanently implanted iodine-125 seed
Patrick C Obasi1, Gene H Barnett, John H Suh
1Howard University College of Medicine, Washington, DC, USA.
Purpose:
To investigate the response and complications of iodine-125 brachytherapy for the treatment of recurrent and newly diagnosed meningiomas. Clinical cases of 2 patients treated with this method are presented.
Materials And Methods:
Thirteen patients with primary and recurrent intracranial meningioma were treated by frameless stereotactic implantation of iodine-125 seeds from January 1996 to June 1998. The total dose to decay ranged from 7,000 to 17,000 cGy, with a dose rate of 5-10 cGy/h.
Results:
All 11 evaluable patients had a decrease or stabilization in the size of their lesions as detected by MRI during follow-up. There were no acute complications. All patients who received a total dose greater than 10,000 cGy had postoperative radiation necrosis and/or vasogenic edema while only 20% of the patients who received doses of 10,000 cGy or less had radiation changes (p = 0.002).
Conclusions:
MRI-guided stereotactically assisted permanent implantation of iodine-125 seeds seems to be a safe, effective and noncomplicated method for the treatment of primary and recurrent meningiomas for selected patients, when doses are limited to 10,000 cGy.